title: Association of brief health literacy screening and blood pressure in primary care.
abstract: Health literacy impacts health outcomes. However, the relationship to blood pressure is inconsistent. This study aimed to determine whether health literacy, assessed by clinic staff, is associated with blood pressure among patients with hypertension. The design was a cross-sectional study of a large sample of primary care patient encounters in 3 academic medical center clinics in Nashville, Tennessee. Health literacy was assessed using the Brief Health Literacy Screen, with higher scores indicating higher health literacy. Blood pressure was extracted from the electronic health record. Using 23,483 encounters in 10,644 patients, the authors examined the association of health literacy with blood pressure in multivariable analyses, adjusting for age, gender, race, education, and clinic location. Independent of educational attainment, 3-point increases in health literacy scores were associated with 0.74 mmHg higher systolic blood pressure (95% CI [0.38, 1.09]) and 0.30 mmHg higher diastolic blood pressure (95% CI [0.08, 0.51]). No interaction between education and health literacy was observed (p = .91). In this large primary care population of patients with hypertension, higher health literacy, as screened in clinical practice, was associated with a small increase in blood pressures. Future research is needed to explore this unexpected finding.
authors.affiliation: a Henry Ford Health System, Department of Medicine , Detroit , Michigan , USA.
authors.forename: David E
authors.initials: DE
authors.lastname: Willens
authors.forename: Sunil
authors.initials: S
authors.lastname: Kripalani
authors.forename: Jonathan S
authors.initials: JS
authors.lastname: Schildcrout
authors.forename: Courtney
authors.initials: C
authors.lastname: Cawthon
authors.forename: Ken
authors.initials: K
authors.lastname: Wallston
authors.forename: Lorraine C
authors.initials: LC
authors.lastname: Mion
authors.forename: Corinne
authors.initials: C
authors.lastname: Davis
authors.forename: Iona
authors.initials: I
authors.lastname: Danciu
authors.forename: Russell L
authors.initials: RL
authors.lastname: Rothman
authors.forename: Christianne L
authors.initials: CL
authors.lastname: Roumie
mesh_terms: D000046:Academic Medical Centers; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D003430:Cross-Sectional Studies; D057286:Electronic Health Records; D005260:Female; D057220:Health Literacy / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D015999:Multivariate Analysis; D011320:Primary Health Care / Q000706:statistics & numerical data*; D013714:Tennessee